What is the chronic pelvic pain syndrome?
Chronic pelvic pain syndrome is an entity or pathology of those pathological processes that reside in the pelvic floor. It is a pain that is presumed to be more than six months in duration.
What types of pain exist and what causes them?
As we can see, the pelvic floor is a very wide structure. In this structure are collected organs aimed at very diverse functions such as the nervous system, the digestive system, urinary system and the muscular theme. Here we have a muscular cup that gathers all the support of the viscera of the abdomen. Any of these structures can cause pathology or pain in the pelvic floor. For that we must first diagnose what is the origin of that pain. As a neurophysiologist, I check two of these structures: the muscular system and the nervous system. Mainly two entities, the myofascial picture of the pelvic floor and the neuropathy of the pudendal nerve.
What is the treatment and can this pain be relieved?
The treatment of chronic pelvic pain requires the most accurate diagnosis. Once the etiology has been established, in my case from the muscular or nervous point of view, we focus the treatment. Treatment must be individualized. In the case of pudendal neuropathy, we first establish the severity of the condition and which nerve structures are involved. The first step is analgesics. Most of the usual analgesics are not effective for this type of pathology. Only opioid analgesics are mildly effective. We have neuropathic pain modulating drugs, such as antiepileptics. And a third step would be infiltrations. The infiltrations can be done on nerve structures, what we call blocks, or infiltrate directly on the supporting structures, that is to say the muscles, desensitizing infiltrations. All this treatment also passes through the hands of our physiotherapists. Physiotherapists have an extremely important job, because the exit door of any injury to the pelvic floor is usually a myofascial picture, in which the muscles are shortened and we must return the initial length that these muscles had.